Relationship Between Gestational Diabetes Mellitus and Postpartum Diastasis Recti Abdominis in Women in the First Year Postdelivery

Jingran Du; Juntong Ye; Hui Fei; Mengxiong Li; Juan He; Yun Liu; Lixiang Liu; Yangliu Ye; Juanhua Li; Lili Hou; Yang Xu; Haixia Zhang; Changlin Zhang; Tian Li

doi:10.1093/ptj/pzad102

Relationship Between Gestational Diabetes Mellitus and Postpartum Diastasis Recti Abdominis in Women in the First Year Postdelivery

Phys Ther. 2023 Oct 3;103(10):pzad102. doi: 10.1093/ptj/pzad102.

Authors

Jingran Du¹, Juntong Ye¹, Hui Fei¹, Mengxiong Li¹, Juan He¹, Yun Liu¹, Lixiang Liu¹, Yangliu Ye¹, Juanhua Li¹, Lili Hou¹, Yang Xu¹, Haixia Zhang¹, Changlin Zhang¹, Tian Li¹

Affiliation

¹ Pelvic Floor Disorder Center, Obstetrics and Gynecology Department, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.

Abstract

Objective: Postpartum diastasis recti abdominis (DRA) influences women's appearance and health. Gestational diabetes mellitus (GDM) can affect the structure of the rectus abdominis muscles. However, the relationship between GDM and postpartum DRA is unknown. The objective of this study was to investigate the relationship between GDM and postpartum DRA.

Methods: This retrospective cohort study included 241 women in the first year postdelivery. Women with GDM were matched with those without GDM using propensity score matching. They underwent an oral glucose tolerance test during pregnancy and a random blood glucose test before delivery. At follow-up, DRA was diagnosed by palpation, and interrectus distance was measured using ultrasound to evaluate the severity of DRA. The strength of the rectus abdominis was evaluated using the manual muscle testing method.

Results: Among the 241 participants, 174 (72.2%) had postpartum DRA, and 46 women with GDM were matched with 46 women without GDM on the basis of propensity scores. Women with GDM had higher odds of experiencing postpartum DRA (adjusted odds ratio = 4.792; 95% CI = 1.672 to 13.736) and larger interrectus distance values at the upper part of the rectus abdominis than those without GDM. There was a weak and positive correlation between the fasting oral glucose tolerance test level and the interrectus distance values (0.267 ≤ r ≤ 0.367).

Conclusion: GDM was associated with postpartum DRA in women in the first year of delivery. Women with GDM had larger interrectus distance values at the upper part of the rectus abdominis than those without GDM. The fasting oral glucose tolerance test level showed a positive and weak correlation with the severity of postpartum DRA.

Impact: Women with GDM have higher odds of experiencing postpartum DRA than those without GDM. The upper part of the rectus abdominis deserves increased focus during and after rehabilitation. Controlling the fasting oral glucose tolerance test level may help reduce the severity of postpartum DRA.

Keywords: Diastasis Recti; Gestational Diabetes; Postpartum.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Diabetes, Gestational*
Diastasis, Muscle*
Female
Humans
Postpartum Period
Pregnancy
Rectus Abdominis / diagnostic imaging
Retrospective Studies